Gateshead Council and PCT

Interview with Steve Bramwell, Director of Community Services

“At the end of the day, the strength of our partnership has always been our willingness to work at it and our drive to make it happen. When difficulties come you can't duck out of them.”

So says Steve Bramwell, Gateshead Metropolitan Borough Council's Group Director for Community Based Services. There is a strong philosophy in the borough, says Bramwell, that partnerships are about a realisation of common needs, not about bureaucratic meetings.

“It's about people coming together and working together for the common good.”

He says this has sustained the partnership for over 10 years, as has the commitment of the authority and the role that it has played.

“There is an expectation that we in local government are committed to partnerships. We do take it seriously and we make demands of our partners around that.”

Strong personal relationships

He says strong personal relationships in the borough have played a huge part in the partnership.

“People can make things happen regardless of structures and we've worked very hard at personal relationships. Regardless of the ups and downs these have always been strong and we've always been able to ask a lot of each other. If we need them we know they'll always be there.”

But such relationships can also be a hindrance. He says few of the original people in the partnership are still around and while partnerships are embedded culturally in Gateshead, constantly changing faces ultimately impacts on its work.

“When people change it takes time to rebuild those relationships and you have to take your eye off the ball.”

He says the partnership is currently going through a period of difficulty following health reorganisation last year with people and structures changing. The PCT management is no longer coterminous with the council and has a shared management team split between three areas. The mental health trust has also grown and now covers six council areas. He regrets these changes and says the partnership worked best when everyone concentrated solely on the people of Gateshead. The changes, he says, are causing remoteness between the two partners.

“It is making it more difficult to have a common philosophy and it's certainly harder than it was previously. But we have to constantly talk to our partners and understand each other's needs. I'm sure we'll overcome it.”

Overcoming the challenges

He concedes that there are different cultures in health and local government, with health more risk averse and centrally controlled.

“There have been differences to overcome and there wasn't always the respect that should have been there. We have worked hard at that. We have different drivers but the same aim. We have to understand that its pointless saying ‘it's not right' or ‘it's not fair', sooner or later you have to help each other through things.”

What has helped the partnership over the years is high service performance across the partners, Bramwell says. The council has excellent status and the PCT has three stars and this 'rubs off' on others.

“We all work together to help each other achieve as high a performance as we can.”

As a partnership its cancer rates and the health of women are improving faster than the national average, but overall Gateshead is still an unhealthy place to live.

“We've had some success but we're not there yet. The proof is in the pudding and you can do all the things in the world, but you still need to focus on outcomes.”

The main driver for people working in the partnership in Gateshead is the desire to make Gateshead a better place to live, says Norma Harris, Director of Governance and Corporate Development at Gateshead PCT.

This has made local people think creatively about how they can change the area. She says:

"Gateshead started to think about how it could create some momentum and it has managed to achieve things that 20 years ago would have been considered impossible."

Antony Gormley's Angel of the North, which towers over the A1 as you approach the city, BALTIC Centre for Contemporary Art, the Sage Gateshead - a world class music venue and the Millennium Bridge linking Gateshead to Newcastle, as well as the Gateshead International Stadium are all examples of how the city has become a leading cultural destination.

This sense of optimism about what can be achieved has spread across the public sector, says Harris.

"When someone says that it's hard to do something we can point to what's been achieved here."

The partnership between the council and PCT has been nurtured over a number of years, says Harris.

"There's a recognition that the broader NHS agenda about improvement of health is not something that the NHS can do on its own. We must work in partnership with other organisations. It's easy to say but it's harder to do. The relationship with Gateshead Council has been built up over a number of years and both partners can see the mutual benefit."

Harris points to Gateshead's work on teenage pregnancy as an example of where joint working has had tangible benefits. The latest figures from the Office for National Statistics show that between 1998 and 2005 Gateshead cut its under-18 conception rate by 22.4 per cent - the third consecutive fall in teenage pregnancy rates in the borough. The council has also won beacon status for its work in this area.

"We would never have achieved this if we hadn't worked together. We do a lot of work in schools on changing expectations and aspirations and increasing self-esteem. It's all part and parcel of the [teenage pregnancy] strategy."